Healthcare Provider Details

I. General information

NPI: 1679697882
Provider Name (Legal Business Name): JACQUELINE GAYLE-NICHOLSON CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JACQUELINE GAYLE CNM

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 02/06/2026
Certification Date: 02/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2553 E SILVER SPRINGS BLVD
OCALA FL
34470-7009
US

IV. Provider business mailing address

2553 E SILVER SPRINGS BLVD
OCALA FL
34470-7009
US

V. Phone/Fax

Practice location:
  • Phone: 352-732-6599
  • Fax:
Mailing address:
  • Phone: 352-732-6599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberARNP2514592
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: